Diabetologia：基于风险的个体化可变区间筛查糖尿病视网膜病变的视力受损

2018-01-30 MedSci MedSci原创

近日，国际杂志《Diabetologia》上在线发表一项关于基于风险的个体化可变区间筛查糖尿病视网膜病变的视力受损的风险计算研究。基于风险的个体化可变区间筛查糖尿病视网膜病变提供了更好的靶向性，且能够改善成本效益。研究人员开发了一个通用的风险计算引擎（RCE）来分配与当地人口特征相关联的个性化区间，并且与当前的实践相比探索了分配上的差异。资料来源于5年的镜下筛查和糖尿病患者初级保

近日，国际杂志《Diabetologia》上在线发表一项关于基于风险的个体化可变区间筛查糖尿病视网膜病变的视力受损的风险计算研究。

基于风险的个体化可变区间筛查糖尿病视网膜病变提供了更好的靶向性，且能够改善成本效益。研究人员开发了一个通用的风险计算引擎（RCE）来分配与当地人口特征相关联的个性化区间，并且与当前的实践相比探索了分配上的差异。

资料来源于5年的镜下筛查和糖尿病患者初级保健的数据。从使用混合定性/定量方法创建的数据集中选择协变量。针对本地队列的历史，马尔可夫模型预测筛查阳性的进展（可参考糖尿病视网膜病变）。视网膜病变分级明确的基线风险和多重归因处理缺失的数据。患者和专业终端用户可以接受的时间间隔为（6,12,24个月）和风险阈值（2.5％）。数据来自11,806例糖尿病患者（46,525例发作期，388例筛查阳性）。具有足够预测价值的协变量为：已知疾病的持续时间，HbA 1c，年龄，收缩压和总胆固醇。校正的AUC（95％CI）为：6个月0.88（0.83,0.93），12个月0.90（0.87,0.93）和24个月0.91（0.87,0.94）。2.5％风险的敏感性/特异性为：6个月0.61,0.93,12个月0.67,0.90和24个月0.82,0.81。实施个性化的基于RCE的间隔将使在分配的筛选日期之前筛选阳性的人的比例减少> 50％，并且发作的数量减少30％。

在更广泛的实施之前，利物浦RCE表现出良好的性能，可以在当地引入实践，但需要经过外部验证。这种方法改善了筛选的可行性，提高了适用性和成本效益。

原始出处：

Antonio Eleuteri, Anthony C. Fisher, Deborah M. Broadbent, et al. Individualised variable-interval risk-based screening for sight-threatening diabetic retinopathy: the Liverpool Risk Calculation Engine.

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2018-12-09 ms9608593228839890

#DIA#

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2018-09-11 ms5439512287675881

#BET#

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2018-02-01 zutt

#视网膜#

23 0
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encodeId=660e28369e25, content=^_^^_^^_^^_^, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Swp2ehfHpiciczeTntUyQOlIGMzQ705ic67sdMTVMbwTv7KbmlUvxrGvRSvQZjPkz7ib5tEDfIaORgczPtmHDpwojg/0, createdBy=c54b2163125, createdName=wqkm, createdTime=Wed Jan 31 05:56:08 CST 2018, time=2018-01-31, status=1, ipAttribution=)]
2018-02-01 zhanfl

#视网膜病变#

0 0
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encodeId=660e28369e25, content=^_^^_^^_^^_^, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Swp2ehfHpiciczeTntUyQOlIGMzQ705ic67sdMTVMbwTv7KbmlUvxrGvRSvQZjPkz7ib5tEDfIaORgczPtmHDpwojg/0, createdBy=c54b2163125, createdName=wqkm, createdTime=Wed Jan 31 05:56:08 CST 2018, time=2018-01-31, status=1, ipAttribution=)]
2018-02-01 zhouqu_8

#个体化#

21 0
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2018-01-31 明月清辉

谢谢分享.学习了

48 0
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2018-01-31 飛歌

厉害了我的哥

38 0
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2018-01-31 121832a9m88暂无昵称

学习了

47 0
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encodeId=660e28369e25, content=^_^^_^^_^^_^, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Swp2ehfHpiciczeTntUyQOlIGMzQ705ic67sdMTVMbwTv7KbmlUvxrGvRSvQZjPkz7ib5tEDfIaORgczPtmHDpwojg/0, createdBy=c54b2163125, createdName=wqkm, createdTime=Wed Jan 31 05:56:08 CST 2018, time=2018-01-31, status=1, ipAttribution=)]
2018-01-31 秀红

学习了

36 0
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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=283713, encodeId=400d283e13e6, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a8f22260741, createdName=121832a9m88暂无昵称, createdTime=Wed Jan 31 06:08:50 CST 2018, time=2018-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=283703, encodeId=e036283e033c, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/01/15/8213228fe923915543544ad3da7e1c64.jpg, createdBy=6bd82014262, createdName=秀红, createdTime=Wed Jan 31 06:03:40 CST 2018, time=2018-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=283697, encodeId=660e28369e25, content=^_^^_^^_^^_^, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Swp2ehfHpiciczeTntUyQOlIGMzQ705ic67sdMTVMbwTv7KbmlUvxrGvRSvQZjPkz7ib5tEDfIaORgczPtmHDpwojg/0, createdBy=c54b2163125, createdName=wqkm, createdTime=Wed Jan 31 05:56:08 CST 2018, time=2018-01-31, status=1, ipAttribution=)]
2018-01-31 wqkm

^_^^_^^_^^_^

40 0